For decades, the term "diet" has been associated with weight loss, often through unsustainable and potentially harmful methods. However, it's time to redefine "diet" as a sustainable eating style focused on overall health and well-being. Among various eating styles, the Mediterranean diet consistently emerges as a top choice for heart health and overall wellness.
Registered dietitian Julia Zumpano, RD, LD, emphasizes that the Mediterranean diet is "a lifestyle, not a short-term diet." It prioritizes filling your plate with single-ingredient foods that offer substantial nutritional benefits. This approach is supported by scientific evidence, demonstrating the Mediterranean diet's effectiveness as a heart-healthy eating plan with numerous other health advantages.
Mediterranean Diet: An Overview
The Mediterranean diet emphasizes plant-based foods, healthy fats, and lean proteins, offering versatility and creativity in meal planning. The primary goals are long-term health and longevity.
According to Zumpano, studies of people living in the seven countries around the Mediterranean Sea reveal that their diets are very similar, and they experience fewer health problems.
Key Components of the Mediterranean Diet
Here's a simplified overview of the Mediterranean diet guidelines:
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- Fish: Aim for three servings per week (one serving equals 3 to 4 ounces).
- Extra-virgin olive oil: Consume at least 1 tablespoon daily, but no more than 4 tablespoons.
- Fruit: Have three servings daily (one serving equals 1/2 to 1 cup).
- Vegetables: Eat three or more servings daily (one serving equals 1/2 cup cooked or 1 cup raw).
- Legumes: Include three servings per week (one serving equals 1/2 cup).
- Nuts: Consume at least three servings per week (one serving equals 1/4 cup or 2 tablespoons nut butter).
- Whole grains and starchy vegetables: Aim for three to six servings per day (one serving equals 1/2 cup cooked vegetables, one slice of bread, or 1-ounce dry cereal).
Foods to Embrace on the Mediterranean Diet
The appeal of the Mediterranean diet lies in its accessibility and focus on whole foods.
Fish High in Omega-3s
Fish is a cornerstone of the Mediterranean diet, providing a valuable source of protein. Aim to eat fish about three times a week. While any type of fish can be a good source of protein, fish high in omega-3s have been shown to suppress inflammation.
Omega-3 fatty acids, known as "healthy fats," are abundant in fish like:
- Salmon
- Tuna
- Herring
- Mackerel
- Sardines
While fresh fish is readily available near the Mediterranean, frozen and tinned fish are also suitable options.
Goal: Three servings per week (one serving = 3 to 4 ounces).
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Other Protein Sources
While fish is a key protein source, the Mediterranean diet also includes other options. Skinless poultry, such as white-meat chicken and turkey, is a preferred choice, followed by plant-based sources.
- Legumes: This category includes dried beans and lentils. Variety is key. Add lentils to a salad instead of meat, make a bean soup, or dip your veggies in hummus, which has tons of protein and fiber. Aim for three servings per week (one serving = 1/2 cup).
- Nuts: Walnuts, almonds, and hazelnuts are commonly eaten in the Mediterranean region. If you favor cashews or peanuts, try to mix them with these other nuts. Just mind your portion sizes, as the calories can add up quickly. Try for three servings per week (one serving = 1/4 cup or 2 tablespoons nut butter).
- Egg whites: There’s no recommended limit on how many egg whites you can eat per week, but eat egg yolks in moderation.
- Greek yogurt: There’s not much dairy involved in the Mediterranean diet, but Greek yogurt gets a pass because it’s so darn healthy.
Extra-Virgin Olive Oil
Extra-virgin olive oil (EVOO) is a staple in the Mediterranean diet, prized for its antioxidant properties. The mechanical pressing of olives without chemicals or heat preserves the phenols, organic compounds with antioxidant effects.
Antioxidants protect the body from cellular damage, slowing the aging process and reducing the risk of diseases. The polyphenols in olive oil have been shown to protect against high cholesterol and high blood pressure.
EVOO enhances the flavor of food, making the Mediterranean diet enjoyable and sustainable. Use EVOO instead of vegetable oil and animal fats, and drizzle it on salads, cooked veggies, and whole-grain pasta.
Goal: Aim for at least 1 tablespoon per day, but no more than 4 tablespoons per day.
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Fruits and Vegetables
Fruits and vegetables are abundant in the Mediterranean diet. Aim to include at least one fruit or vegetable on your plate at every meal.
Fruits and vegetables provide antioxidants, phytochemicals, and phytonutrients. Variety is key to maximizing the nutrients you consume and their benefits. Experiment with new fruits and vegetables and creative ways of preparing them.
Goal: Try to get three servings of fruit per day (one serving = 1/2 to 1 cup) and three or more servings of vegetables per day (one serving = 1/2 cup cooked or 1 cup raw).
Whole Grains and Starches
Choose minimally processed whole-grain foods like oats, quinoa, barley, and brown or wild rice. Processing grains strips them of their outside layers, and oftentimes, heat or chemicals are used to process grains into white flour-based products and snack foods, this process strips most of the nutrients.
Starchy vegetables that also fall into this category include:
- Red skin potatoes
- Sweet potatoes
- Peas
- Corn
- Winter squash (acorn, butternut, delicata, etc.)
Goal: You’ve got some wiggle room here, with a target of three to six servings per day. One serving is 1/2 cup of cooked starchy vegetables, 1/3 cup cooked pasta or rice, a slice of whole-grain bread or 1 ounce of dry cereal.
Limited Dairy
Limit cheese consumption to about 3 ounces per week. Choose natural, light, or part-skim milk cheese and milder varieties like cottage cheese, feta, fresh mozzarella, ricotta, and goat cheese. For other dairy products, choose skim or 1% milk and plain Greek yogurt or low-sugar yogurt. Limit your portions.
Goal: Aim for no more than 3 ounces of cheese per week, and make other smart swaps for full-fat dairy.
Healthier Home-Baked Goods
When baking at home, use nutrient-dense swaps and adjustments:
- Go for whole-grain flour instead of bleached or enriched flour.
- Bake with liquid oil instead of solid fats.
- Use egg whites instead of whole eggs.
- Reduce the amount of sugar in the recipe, and/or use honey or fruit as sweeteners.
Dark chocolate (70% cocoa or greater) can be enjoyed as a dessert due to its antioxidants and flavanols, which promote healthy blood flow and lower blood pressure.
Foods to Avoid or Limit
The Mediterranean diet emphasizes limiting processed foods.
Red Meat
Replace beef, pork, veal, and lamb with fish, poultry, and plant-based protein. If you have progressive heart disease, scale way back on red meat, but if you’re following the Mediterranean diet for overall heart health, red meat can be included in moderation.
Aim for no more than a single, 3-ounce serving per week, and stick to lean cuts like tenderloin, sirloin, and flank steak.
Refined Flour Products
Replace processed options like white bread, white rice, crackers, pretzels, and pastries with healthier whole-grain options.
Full-Fat Dairy
Replace whole-milk dairy, cream, and cream-based sauces and dressings with non-dairy options, when possible, and with fat-free or 1% dairy. Skip sugary, full-fat yogurt in favor of plain, lower-fat yogurts. And nix the processed cheeses, too. Turn instead to light, mild cheeses.
Egg Yolks
Most healthy people can eat up to four to six egg yolks per week while following a Mediterranean diet, but to get some of the benefits of eggs without the negatives, stick to egg whites whenever you can.
Commercial Baked Goods
Packaged cakes, cookies, donuts, and other desserts are loaded with sugar and refined carbohydrates, with little to no nutritional value.
Fried Foods
Stick to baking, broiling, roasting, and grilling your foods, and avoid the urge to fry - though the exceptions are air-frying and pan-frying, which can be both delicious and healthy.
Benefits of Following the Mediterranean Diet
The Mediterranean diet offers numerous benefits with virtually no downsides.
- Protects your heart: This cardiologist-recommended diet has been proven time and again to be the healthiest for your heart. A 2018 study found that people who followed the Mediterranean diet for five years had a 30% lower risk of heart attack, stroke and cardiovascular-related death than those who ate a low-fat diet during the same time.
- Reduces inflammation: The Mediterranean diet is a type of anti-inflammatory diet. Inflammation degrades our body’s ability to work at peak capacity, which eventually leads to disease. But this eating style creates anti-inflammatory chemicals and enzymes that work to suppress inflammation and protect your body.
- Lowers your risk for certain diseases: Inflammation raises your risk of dementia, cancer, gut-related health concerns and more. But reducing inflammation, like by eating a Mediterranean diet, reduces that risk.
- Other benefits: The Mediterranean diet is also associated with better brain function, stable blood sugar, a healthy gut, and a lower risk of certain cancers - all good things, and all associated with longevity.
Getting Started with the Mediterranean Diet
The Mediterranean diet is a lifestyle, not a restrictive fad diet. Start by incorporating a fruit or vegetable into every meal and exchanging processed snacks for healthier ones. As you get comfortable, experiment with new ingredients and recipes to expand your options.
The Cleveland Clinic Diet App
The Cleveland Clinic Diet app is a wellness tracker designed to educate users on nutrient intake and improve health and well-being. It helps consumers focus on healthy eating for overall health rather than just weight loss.
Key Features of the App
- Individualized plans: Users are guided into the HeartSmart (heart-friendly) or BodyGuard (overall well-being) programs based on their health history, habits, and personal goals.
- Five pillars of well-being: Both plans are based on nutrition, physical activity, sleep, stress relief, and social connectedness.
- Tracking: Nutrients, foods, and fitness are tracked throughout the day for a daily summary, along with continuous progress tracking over time.
- Resources: A wealth of courses, articles, recipes and meal plans is available to support sustainable lifestyle changes.
How the App Works
Based on the initial questionnaire, users are placed into one of two groups. The BodyGuard plan is designed for overall health, to reduce inflammation, promote weight management and minimize triggers of overeating. It encourages nutrient-rich foods that are high in fiber and healthy fats. The HeartSmart plan is geared toward heart health and is similar to the BodyGuard but focuses on limiting sodium and saturated fat.
The app generates a nutrition and wellness plan based on your personal details, including your age, sex, height, weight, activity level and health status. After completing the questionnaire, your weight goals, calorie budget, and daily nutritional and workout goals are displayed.
In addition, a curated wellness course is provided. For best results, you should complete this within the first week of the program.
Users track their food and fluid intake along with fitness activities each day. Daily reports and cumulative progress trackers are provided. Educational materials, wellness courses, healthy meal plans and recipes help users adhere to their plans and ultimately improve their diet and overall health.
Getting Started with the App
Download the app, complete the guided questionnaire, set up an account, and decide if you want to receive automatic notifications and reminders. Once you have received your individualized plan, you are encouraged to review the wellness course and start logging your food and exercising daily while making small changes in your lifestyle.
Potential Benefits of the App
The Cleveland Clinic Diet app can help you lose weight, but it requires self-motivation and accountability. Personalized plans help users manage calorie and nutrient intake, make wiser food choices and improve overall health and well-being. With food tracking, the goal is to reduce added sugars, sodium, refined carbohydrates and saturated fat while increasing nutrient and fluid intake and simultaneously stepping up your level of physical activity.
It is always a good idea to consult your health care provider to discuss your health before starting a diet or exercise regime.
Who Should Avoid the App?
The app won’t work for everyone. It takes someone who is organized, understands health and nutrition, is comfortable with technology and can manage their own meal plans independently. Reliance on technology and accuracy of self-assessment are potential risks.
Individuals with eating disorders may find the detailed tracking can escalate their condition and should follow a different type of plan.
Additionally, children, elderly, individuals who are underweight, malnourished, have chronic conditions, such as kidney disease or cancers, may warrant a more hands-on approach from a registered dietitian nutritionist than the app.
Foods Recommended and to Avoid on the App
Fruits, vegetables, whole grains, lean meats, plant proteins, dairy, seafood, beans, nuts and dairy are the basis of the recommended foods. The app flags foods high in added sugars, saturated fat, sodium and calories, but it does not restrict them completely. The app focuses on meeting your body’s needs, and you choose the best foods to meet those needs.
The Anti-Inflammatory Aspect of the Mediterranean Diet
The Mediterranean diet is considered an anti-inflammatory diet. Chronic inflammation can damage your heart, brain, and other organs, playing a role in major illnesses like cancer, heart disease, Alzheimer’s disease, and depression.
Benefits of an Anti-Inflammatory Diet
The health benefits of an anti-inflammatory diet include:
- Clearer skin
- Decreased muscle or joint pain
- Decreased swelling in your hands and feet
- Fewer headaches
- Improved gastrointestinal symptoms (diarrhea, gas, nausea, stomach pain)
- Improved sleep
- Less anxiety, stress and/or brain fog
- Less bloating
- Lower blood pressure
- Lower blood sugar
- More energy
- Weight loss
Foods to Eat and Avoid for Inflammation
Focus on whole foods and minimally processed foods. An anti-inflammatory food list may include:
- Fresh fruit: Like apples, berries, avocados and oranges
- Fresh vegetables: Like leafy greens, peppers and broccoli
- Lean protein: Like chicken and turkey
- Fatty fish: Including salmon, tuna, herring or mackerel
- Whole grains: Like brown rice, wild rice and oats
- Legumes: Like dried beans and peas
- Nuts and seeds: Including walnuts
- Spices: Like turmeric and cinnamon
- Healthy oils: Like extra virgin olive oil (EVOO)
On the other hand, there are certain foods you should avoid or limit, including:
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